Diagnostic ability of duplex Doppler ultrasonography reling on resistive index is limited when clinical symptoms and signs of rejection are subtle or renal dysfunction is caused by other conditions such as urinary tract infection. To investigate the significance in the changes of renal pelvis, a combined analysis of resistive index and ultrasonographic findings in cases of renal pelvis dilatation and mucosal thickening was undertaken. A mean resistive index was calculated from Doppler measurements of the main, segmental and interlobar arteries. The cause of mucosal thickening was retrospectively analysed using the clinical and laboratory findings. Twenty three cases of renal pelvis dilatation and 17 cases of mucosal thickening were found in a total of 159 renal transplantation cases. In 14 of the 23 cases with renal pelvis dilatation, renal function was normal and their mean resistive index was 0.64±0.04. Pelvis and ureter dilatation caused by ureteral stenosis or compression was demonstrated in 6 cases and their mean resistive index(0.72±0.05)was increased. Mucosal thickening of renal pelvis was found in 7 of 32 cases with acute rejection and in 2 of 13 cases with chronic rejection, but their mean resistive index was not different from that of the cases without pelvic mucosal changes Three cases of acute rejection associated with urinary tract infection and 2 cases of chronic rejection in whom resistive indices were indeterminate, but mucosal thickening of the renal pelvis was prominent at ultrasonography. In renal transplant patients having indeterminate resistive index and mucosal thickening of the renal pelvis, ultrasonographic features must be correlated with the clinical and laboratory findings for an accurate diagnosis and treatment of renal dysfunction.
Arteries ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Humans ; Kidney Pelvis ; Kidney Transplantation ; Kidney* ; Pelvis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Ureter ; Urinary Tract Infections

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

No abstract available.
Carcinoid Tumor*

The discovery of C-T scan have facilitated the detection of post-traumatic hydrocephalus cases. Of those, 6 cases of hydrocephalus of non-parenchymatous in origin, in other words, normal pressure hydrocephalus were presented. They were diagnosed by repeated brain C-T and cisternography with Iodine 131-labeled human serum albumin. The symptomatology, diagnosis procedure and surgical results were discussed. Followings are the results. 1) The RIHSA cisternogram taken after 6 hrs, 12 hrs, 24 hrs and 48 hrs from lumbar injection showed abnormal features in all cases. 2) Surgical results were thought that there is much correlation with the age and improvement of mental impairments were seen, more or less, in all cases and improvement of gait disturbance and incontinence were seen in 5 cases and 4 cases respectively. 3) In those who sustained severe head injury with delayed recovery, the authors think, repeated check of brain C-T and cisternography is necessitated to perform the V-P shunt or V-A shunt to relieve the symptomatology of normal pressure hydrocephalus.
Brain ; Cerebrospinal Fluid Pressure ; Craniocerebral Trauma ; Diagnosis ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Iodine ; Serum Albumin ; Ventriculoperitoneal Shunt

No abstract available.
Dilatation* ; Kidney* ; Pelvis*

Neuromyelitis optica (Devic's syndrome) is characterized by acute bilateral visual loss (optic neuritis), acute trans-verse myelitis, near simultaneous development of these optic and spinal symptoms, no other symptoms and involve-ment of the central nervous system. Sporadic reports of patients with neuromyelitis optica in association with tubercu-losis confined to the lungs have appeared over the last years. A 67-year-old man presented with visual disturbance and sudden onset of lower limb weakness. On neurological examination, bilateral visual loss, flaccid paraparesis, hypesthe-sia below T2 dermatome, and extensor plantar responses were noted. Chest X-ray revealed bilateral nodular densities in the upper lung fields and a fluorochrome stain for tuberculosis was positive. Magnetic resonance imaging showed spinal cord swelling and high signal intensity (T2WI) in thoracic spinal cord. We report a case of neuromyelitis optica with pulmonary tuberculosis. It is suggested that this condition might caused by an immune reaction to tuberculosis rather than the use of antituberculosis medication.
Aged ; Central Nervous System ; Humans ; Lower Extremity ; Lung ; Magnetic Resonance Imaging ; Myelitis ; Neurologic Examination ; Neuromyelitis Optica* ; Paraparesis ; Reflex, Babinski ; Spinal Cord ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

OBJECTIVES: Mass poisoning by carbon disulfide (CS2) occurred in a viscose rayon factory in Korea. Up until 1998, 830 employees, including 38 who had died, were diagnosed with CS2 poisoning. Among the CS2 poisoned subjects, heart rate variability (HRV) was evaluated to investigate whether the toxic effect of CS2 persists after the exposure has ceased. The dose-response relationship between carbon disulfide exposure and HRV was also evaluated. METHODS: The case group was comprised of 71 retired male workers diagnosed as being CS2 poisoned. The control group was comprised of 127 males of same age-range who had no history of CS2 exposure and cardiovascular diseases. Information on individual age, height, weight, cigarette smoking, alcohol drinking, regular exercise, medical and occupational history, chest x-ray, and ECG recording of the two groups were collected through a self-administered questionnaire and with a medical examination. Time (maximum, average, minimum RR interval) and frequency domain measures (low frequency - LF, high frequency - HF, total power spectrum TPS, and LF/HF ratio) of the two groups were analyzed. CS2 exposure indices of the case group (duration of employment, exposure level per work department, cumulative exposure index and duration of retirement) were investigated. RESULTS: Using a univariate analysis, the frequency domain measures for the case group were significantly lower than those in the control group, except for HF. In the multivariate analysis, previous history of CS2 poisoning was inversely related to all frequency domain parameters and it significantly affected the LF (p<0.05) and the LF/HF ratio (p<0.05). There was no significant dose-response relationship between CS2 exposure indices and HRV parameters in the case group. CONCLUSION: This study suggests that further studies are necessary to evaluate the residual effects of CS2 poisoning even after the CS2 exposure has ceased.
Alcohol Drinking ; Carbon Disulfide* ; Carbon* ; Cardiovascular Diseases ; Electrocardiography ; Employment ; Heart Rate* ; Heart* ; Humans ; Korea ; Male ; Multivariate Analysis ; Poisoning* ; Questionnaires ; Smoking ; Thorax

BACKGROUND: One of the important factors in the prognosis of chronic hepatitis B patient is the degree of replication of hepatitis B virus (HBV). It has been known that HBV DNA polymerase plays the essential role in the replication of HBV. HBV DNA polymerase is composed of four domains, TP (Terminal protein), spacer, RT (Reverse transcriptase) and RNaseH. Among these domains, tyrosine, the 65th residue of TP is an important residue in protein-priming reaction that initiates reverse transcription. If monoclonal antibody that recognizes around tyrosine residue were selected, it could be applied to further study of HBV replication. METHODS: To produce TP-specific scFv (single-chain Fv) by phage display, mice were immunized using synthetic TP-peptide contains 57~80th amino acid residues of TP domain. After isolation of mRNA of heavy-variable region (VH) and light-chain variable region (VL) from the spleen of the immunized mouse, DNA of VH and VL were obtained by RT-PCR and joined by a DNA linker encoding peptide (Gly4Ser)3 as a scFv DNA fragments. ScFv DNA fragments were cloned into a phagemid vector. ScFv was expressed in E.coli TG1 as a fusion protein with E tag and phage gIII. To select the scFv that has specific affinity to TP-peptide from the phage-antibody library, we used two cycles of panning and colony lift assay. RESULTS: The TP-peptide-specific scFv was isolated by selection process using TP-peptide as an antigen. Selected scFv had 30 kDa of protein size and its nucleotide sequences were analyzed. Indirect- and competitive-ELISA revealed that the selected scFv specifically recognized both TP-peptide and the HBV DNA polymerase. CONCLUSION: The scFv that recognizes the TP domain of the HBV DNA polymerase was isolated by phage display.
Animals ; Bacteriophages* ; Base Sequence ; Clone Cells ; DNA ; DNA Polymerase I ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Mice ; Prognosis ; Protein S ; Reverse Transcription ; RNA, Messenger ; Spleen ; Tyrosine

BACKGROUND: Phage display is the most widely used technique among display methods to produce monoclonal antibody fragment with a specific binding activity. Having a large library for efficient antibody display/selection is quite laborious process to have more than 109 members of transformants. To overcome these limitations, several in vitro selection approaches have been reported. Ribosome display that links phenotypes, proteins, directly to genotype, mRNA, is one of the in vitro display methods. Ribosome display can reach the size of scFv library up to 1014 molecules and it can be further diversified during PCR steps. To select the high affinity scFv from one pot library, we established ribosome display technique by modifying the previously reported eukaryotic translation system. METHODS: To establish the antibody selection system by ribosome display, we used 3D8, anti-DNA antibody. A 3D8 scFv was synthesized in vitro by an in vitro transcription-translation system. The translated 3D8 scFv and the encoding 3D8 mRNA are connected to the ribosome. These scFv-ribosome-mRNA complexes were selected by binding to their specific antigens. The eluted mRNAs from the complexes are reverse transcribed and re-amplified by PCR. To apply this system, antibody library from immunized mouse with terminal protein (TP)-peptide of hepatitis B virus DNA polymerase TP domain was also used. This TP-peptide encompasses the 57~80 amino acid residues of TP. These mRNA/ribosome/scFv complexes by our system were panned three times against TP-peptide. The enrichment of antibody from library was determined by radioimmunoassay. RESULTS: We specifically selected 3D8, anti-DNA antibody, against ssDNA as a model system. The selected 3D8 RNAs sequences from translation complexes were recovered by RT-PCR. By applying this model system, we enriched TP-peptide-specific scFv pools through three cycles of panning from immunized library. CONCLUSION: We show that our translating ribosome complexes are well maintained and we can enrich the TP-specific scFv pools. This system can be applied to select specific antibody from an antibody library.
Animals ; Bacteriophages ; DNA ; Genotype ; Hepatitis B virus ; Mice ; Phenotype ; Polymerase Chain Reaction ; Radioimmunoassay ; Ribosomes* ; RNA ; RNA, Messenger ; Translating